Rates and determinants of 5-year outcomes after atrial fibrillation–related stroke

Notice that they are doing NOTHING on rehabilitation efforts. If you don't measure rehabilitation failures they will NEVER be worked on and improved. It is up to YOU to change that lack of focus.
https://www.mdlinx.com/internal-medicine/medical-news-article/2015/12/14/atrial-fibrillation-nursing-homes-rehabilitation-stroke/6428881/?

Stroke, 12/14/2015 Hayden DT, et al.

Accurate population–wide outcome data are essential to inform health service planning to improve atrial fibrillation (AF)–related stroke (AF–stroke) prevention, and provision of rehabilitation, nursing home, and community supports for AF–stroke survivors. AF–stroke is associated with considerable long–term morbidity, fatality, stroke recurrence, and nursing home requirement. Adequately resourced national AF strategies to improve AF detection and prevention are needed. (Not rehab)

Methods

• The authors investigated rates and determinants of 5-year fatality, stroke recurrence, functional outcomes, and prescribing of secondary prevention medications in AF-stroke in the North Dublin Population Stroke Study.
• Ascertainment included hot and cold pursuit using multiple overlapping sources.
• Survival analysis was performed using lifetables and Kaplan-Meier survival curves, and Cox proportional hazard modeling was performed to identify predictors of death and recurrent stroke.

Results

• Five hundred sixty-eight patients with new stroke were identified, including 177 (31.2%) AF-stroke.
• At 5 years, 39.2% (confidence interval, 31.5-46.8) of ischemic AF-stroke patients were alive.
• Congestive heart failure, hypertension, age <65, 65-74 years, and ≥75 years, diabetes mellitus, prior stroke, transient ischemic attack or thromboembolism, vascular disease and female sex (CHA₂DS₂-VASc) score (hazard ratio [HR], 1.34; P<0.001), CHADS₂ score (HR 1.42, P=0.004), National Institute of Health Stroke Scale (HR, 1.09; P<0.0001), and subtherapeutic international normalized ratio (<2.0) at stroke onset (HR, 3.29; P=0.003) were independently associated with 5-year fatality, whereas warfarin (HR, 0.40; P=0.001) and statin use after index stroke (HR, 0.52; P=0.005) were associated with improved survival.
• The 5-year recurrence rate after ischemic AF-stroke was 21.5% (confidence interval, 14.5–31.3).
• Trends toward greater risk of recurrence were observed for persistent AF (HR, 3.09; P=0.07) and CHA₂DS₂-VASc score (HR, 1.34; P=0.07).
• Nursing home care was needed for 25.9% of patients.

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